Predominance of Radiographical Femoral Component Loosening Signs in Total Knee Arthroplasty for Hemophilic Arthropathy


Koç B., ZÜLFİKAR O. B., Arzu U., Atasoy İ. T., Ege M., POLAT G.

Haemophilia, 2025 (SCI-Expanded) identifier identifier

  • Yayın Türü: Makale / Tam Makale
  • Basım Tarihi: 2025
  • Doi Numarası: 10.1111/hae.70155
  • Dergi Adı: Haemophilia
  • Derginin Tarandığı İndeksler: Science Citation Index Expanded (SCI-EXPANDED), Scopus, Academic Search Premier, EMBASE, MEDLINE
  • İstanbul Üniversitesi Adresli: Evet

Özet

Aim: To compare the frequency and timing of femoral- versus tibial-sided radiographic radiolucencies after posterior-stabilized TKA in people with haemophilia (PwH) versus non-haemophilic controls. Methods: A retrospective analysis was conducted of all primary posterior-stabilised total knee arthroplasties (TKA) performed in the centre between December 2003 and December 2018. Patients in Group 1 (n = 53) were age- and implant-matched to controls without haemophilia in Group 2 (n = 58). Radiographs were obtained at 3, 6 and annually to 5 years. Loosening was defined as progressive radiolucent lines >1 mm and/or migration/osteolysis, adjudicated by two blinded surgeons. Results: Mean age at surgery was 35.7 ± 9.2 years in Group 1 and 60.5 ± 11.8 years in Group 2 (p < 0.001). Femoral component loosening occurred in 22.6% of PwH versus 5.2% of controls (p = 0.011), whereas tibial loosening rates were 11.3% versus 8.6% (p = 0.755). Mean time to femoral loosening was 27.6 ± 16.8 months (Group 1) versus 31.3 ± 13.9 months (Group 2; p = 0.788), and to tibial loosening was 20.4 ± 18.2 months versus 9.6 ± 9.5 months (p = 0.134). Cox regression showed no significant hazard difference for femoral loosening (HR 0.99, 95% CI 0.93–1.05; p = 0.693). Post hoc power for detecting femoral loosening differences was ∼80%. Conclusions: PwH undergoing TKA showed a higher frequency of femoral-sided radiographic radiolucencies. These findings should be interpreted as potential predisposition to early loosening. Tibial findings were comparable between groups.